Individual
SHERRY ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 W BROADWAY, 401, ARDMORE, OK 73401
(580) 745-9610
(580) 745-9891
Mailing address
13040 SHIRLEY LN, CHOCTAW, OK 73020-6659
(918) 424-2496
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708380
—
OK
Enumeration date
05/19/2014
Last updated
04/17/2023
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